Saliva tests for the coronavirus are currently being deployed in schools. It is not easy to navigate the complexity of the current recommendations and between the different screening tests. When to test your child and where to turn?
PCR or antigen test, what's the difference?
The antigen test detects the presence of Sars-Cov-2 virus antigens, it is a rapid diagnostic orientation test (TROD). The advantage: results are obtained in 10 minutes. On the other hand, it is less sensitive than a PCR: for it to be positive, you need a high viral load. This is therefore useful when a child has symptoms and we need to know quickly if he is a carrier of Sars-Cov-2. On the other hand, if the child has no symptoms and a screening test is necessary, it is better to give preference to the PCR test, a genomic amplification test, which is therefore more sensitive.
To know : Since the appearance of the variants, the Directorate General of Health recommends in the event of risky contact an antigen test immediately followed, in the event of positivity, by a PCR to check for variants.
My child is sick, should I give him a test?
No question of multiplying the tests in the face of a common cold. The behavior to be taken is different depending on the age of the child. "Rhinoviruses continue to circulate in children even if, thanks to barrier gestures, children are less sick than in previous winters. Runny nose, fever, before 6 years old, the probability that the child will have the Covid is tiny", reassures Dr Fabienne Kochert, pediatrician and president of the French Association for Ambulatory Pediatrics."If the child has a fever, we isolate him, we do not put him in a community. If this continues beyond three days, see the pediatrician or doctor who knows the child. He will check to see if it is not sore throat, laryngitis or otitis that can cause these symptoms. He will decide whether a test is appropriate if no cause for the fever is found."In the event of a fever, the action to be taken is the same as outside the Covid period: if the fever is poorly tolerated (amorphous child, bad coloring, unusual behavior), you must consult.
If the child is over 6 years old, it's different. "In general, after 6 years, the child has made his immunity, he is armed against seasonal viruses"explains the pediatrician. In case of fever after 6 years, you must be vigilant, even if, in the absence of risky contact, the probability of having Covid is low."With the circulation of variants today, we must be extra careful. In case of cough accompanied by fever, it is necessary to consult quickly. "In children, it is advisable to start with a clinical examination by the doctor."Pediatricians are not in favor of "all-round" PCRs without prior clinical examination ", specifies Dr Fabienne Kochert. "Imagine the child has meningitis, if his condition gets worse, time is wasted waiting for the COVID test result."
It is then up to the parents to judge according to the child's condition: if he has a fever peak in the morning, then nothing more, keep him under observation. But if the fever lasts more than 24 hours, you should consult. In this case, a screening test is recommended: antigen test (at the doctor's office if possible) or PCR test. "Pediatricians have a preference for carrying out the antigen test in the doctor's office, on the one hand because they are used to taking samples, on the other hand because they can explain the conclusions of the test and the conduct of the test. hold on to parents", adds Dr Fabienne Kochert.
Finally, whatever his age, your child has a runny nose and he must be looked after by his grandparents? If you are in doubt and need reassurance, performing an antigen test can be helpful. It has to be done on the same day because it is only of value in a very short period of time.
My child is in contact, when to have a test?
If a member of the household is contaminated, it is necessary to follow the advice of the "contact-tracing" of the Health Insurance. The protocols evolve according to the variants. Today, the child is isolated 10 days, then 7 days after the person is healed. The child is tested immediately, then he is retested 17 days later, on release from isolation. In this case, the PCR test is indicated.
If the child is less than 6 years old, he is isolated, but he will not necessarily be tested. If he's small and healthy, there's no need to sample him.
Precautions to be taken: The infected person in the home must wear a mask and isolate themselves, especially when eating.
Finally, if the child is in contact with a sick person outside the home, it must be isolated 7 days after the last contact and then carry out a PCR test after 7 days.
A child is tested for Covid + in his class, how to react?
In nursery or nursery school, if children do not wear a mask, all classmates are considered as a contact case, they are then placed in solitary confinement. A test is not necessarily necessary if the child has no symptoms.
In primary school, as all the pupils wear masks, their classmates are not considered to be contact at risk. "But if there has been contact without a mask, for example, during a lunch in the canteen, a screening test will be necessary. »Adds the pediatrician.
Are there any risks in doing a PCR or antigen test in children?
"Whether it is a PCR or an antigen test, the sampling technique is the same", explains Dr Fabienne Kochert."The sample is taken where the virus is present, namely in the nasopharynx. This is the same type of sample as that taken for influenza viruses. Pediatricians in particular have mastered the gesture and there is no risk for children."
Can we order a saliva test?
The saliva tests are analyzed by "RT-PCR" (Reverse Transcriptase – Polymerase Chain Reaction), it's just the sampling technique that changes: PCR is performed on a saliva sample and not on a nasopharyngeal sample. They are currently reserved for studies in schools. Currently, they are not used for diagnostic purposes in sick children or in contact cases, even though their indications will probably change.
My child has tested positive, what should I do?
"Covid is not a risky disease in children"reassures Dr Fabienne Kochert. “The main risk of having a severe form is to be over 65 years old. Most children are asymptomatic carriers: they were screened because they were most often in contact with their family. no longer go to the community and stay at home ". As for the Kawasaki-like inflammatory syndrome (PIMS) described at the start of the epidemic, it corresponds to a runaway immune response following contamination by the virus. It only concerns a minority of children. In all cases: if a child has been diagnosed positive for Sars-Cov-2 and his condition worsens, it is necessary to consult again.
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